NEW FiTness - Exercise

Cardiovascular exercise helps to strengthen the heart, lungs and circulatory system. Training the cardiorespiratory system results in greater energy reserves and better capacity to cope with tasks of everyday living, such as walking up stairs and playing with your children. Most women find – even in the first trimester – that they become out of breath and feel fatigued much more quickly compared to before they were pregnant. Engaging in cardiovascular exercise can help to offset this shortness of breath and fatigue.

What types of cardiovascular exercise should I do? Walking is one of the easiest ways to engage in cardiovascular exercise. It requires no equipment, and you can do it nearly anywhere. A stationary exercise bike and dancing are two other options. Water aerobics is also an excellent option, especially later in the pregnancy when being on your feet for prolonged periods of time can lead to leg swelling. The pressure from the water helps to reduce the swelling.

How much cardio should I do? If you are new to exercise, start with a 10- to 20-minute walk 2 to 3 days per week. Each day or week, increase the time you spend walking or walk at a faster pace. Work toward walking for 30 minutes most days per week, or start with this amount if you are already accustomed to exercising. The same idea applies to other types of cardio. Start with shorter times, distances or intensities and slowly increase.

How intense should my cardio be? Use the "talk test" to gauge the appropriate intensity. You should be able to carry on a conversation while engaging in exercise. If you are so out of breath that you can’t, decrease the intensity. Your rate of perceived exertion should be about a 7 out of 10, or considered “somewhat hard.”

Strength (or resistance) training aims to strengthen the musculoskeletal system. It can be accomplished using a person’s own body weight, free weights such as dumbbells or barbells, resistance bands, or machines. It is safe to continue resistance training throughout pregnancy without any adverse effects on growth and health of your baby, as long as you follow safety guidelines.

What are the benefits of resistance training? Resistance training helps support increased breast size, body weight and postural changes that occur during pregnancy. Abdominal and back strengthening helps prevent back pain – a very common ailment during pregnancy. Having a strong musculoskeletal system will make carrying your baby (and all that baby equipment) easier.

What should I avoid while resistance training? In general, most resistance training exercises that are safe for you to do outside of pregnancy are also safe during the first trimester, as long as they do not cause you pain. You should always avoid any exercise that causes you pain. As you progress through your second and third trimesters, avoid the following:

• Extending your hip past the neutral position (i.e., extending your leg(s) back behind you, such as during back extensions or the prone cobra position) – This can put extra tension on your pelvic ligaments, which are already getting stretched out to accommodate your baby.
• Lying flat on your back for prolonged periods of time – You may find you become dizzy or nauseated while lying on your back. If this happens, roll onto your left side and your symptoms should improve.
• Deep twisting/rotating through your torso – This puts undue strain on your pelvic ligaments.
• Valsalva (holding your breath and bearing down) – This is a technique often used by experienced weightlifters during exercises such as squats and deadlifts. During pregnancy, this will put extra tension and stress on your pelvic floor and abdominal wall, which is already getting stretched out from your growing uterus.

How often and for how long should I engage in resistance training? If you are new to resistance training, start with 20 – 30 minutes 1 to 2 days per week, engaging all major muscle groups (all body parts) each session. If you are accustomed to resistance training or enjoy it and wish to do it more frequently, it is generally safe to train for 30 – 60 minutes 4 to 6 days per week.

How intense or heavy should my resistance training be? You should be able to perform at least 10 – 12 repetitions of an exercise. If you are unable to, you should lighten the load. You will likely find that as you progress through your second trimester and into your third, you will need to decrease the intensity of your resistance training sessions. This is normal and expected.

Can I do crunches and other abdominal exercises? Crunches and all other abdominal exercises that are safe outside of pregnancy are generally safe during the first trimester and possibly early second trimester. Usually at some point during the second trimester, abdominal work needs to be modified to decrease stress on the abdominal wall as it becomes stretched with your expanding uterus.

Avoid any exercises or movements that cause “coning” or “doming” of the abdomen. You will likely find that coning/doming occurs if you try to perform crunch type exercises in your late second and third trimesters. Continuing this exercise puts you at higher risk of developing or worsening existing diastasis recti, which is a separation of the abdominal muscles down the midline.

Stretching can be accomplished several ways:

• Prenatal yoga can be a safe and helpful way to stretch.
• Static stretching – With this type of stretching, you are not moving but are holding a muscle still in a stretched position.
• Dynamic stretching – With this type of stretching, you move your joints through a range of motion as you stretch.

How often and for how long should I stretch? Stretch for at least 10 – 15 minutes most days of the week. If you enjoy it and want to stretch for longer, go for it. Try 5 – 10 minutes of dynamic stretching before a resistance training or cardio workout followed by 5 – 10 minutes of static stretching after the workout.

What should I avoid while stretching? The particular movements that you should avoid during resistance training are the same things to avoid while stretching. Take a look at the What should I avoid while resistance training? section above.

For women with uncomplicated pregnancies, exercise during pregnancy is generally safe. However, you should take certain precautions ensure you are exercising safely:

• Stay hydrated. Your pregnant body requires more water intake than you did before pregnancy. Be sure to stay hydrated, especially while exercising. Drink at least 8 – 12 glasses of water per day.
• Have a snack before you start. Pregnant women are at risk of low blood sugar, which can be provoked by exercise. Have a snack comprised of protein and carbohydrates before you exercise. For example, you could have a hard-boiled egg and whole grain toast, some chicken breast and brown rice, or Greek yogurt and rice cakes with a piece of fruit.
• Get up slowly. It is not uncommon for pregnant women to get lightheaded when standing up. Be sure to stand up slowly.
• Stop when you feel fatigued. Pregnancy is not the time to “push it” with your exercise routine. When you feel fatigued, it is time to stop.
• Stay cool. The pregnant body does not regulate temperature as well as a person who is not pregnant. Take caution not to overheat. Wear loose-fitting clothing and avoid exercising outside on hot days. Be sure to drink plenty of water.

Always check with your doctor prior to starting an exercise program.

Exercise is considered generally safe and is recommended during uncomplicated pregnancies. Always check with your doctor before starting an exercise program to be sure it is safe for you to exercise. If you experience any of the symptoms below, stop exercising immediately and contact your doctor:

• Vaginal bleeding
• Abdominal pain
• Regular painful contractions
• Leakage of vaginal fluid
• Shortness of breath prior to exercise
• Problems with balance
• Dizziness
• Headache
• Chest pain
• Calf pain/swelling

There are certain things that you should avoid altogether while exercising.

Any trimester:

• Scuba diving
• Contact sports or sports that pose a fall risk (soccer, basketball, gymnastics, volleyball, rafting, downhill skiing or snowboarding)
• Exercising at altitudes higher than 6,000 feet above sea level
• Weightlifting belts

Second trimester and beyond:

• Valsalva maneuver
• Hip extension past neutral (walking lunges, back/hip extensions, glute "kickbacks")
• Deep twisting through the torso (oblique twists/spinal rotations, seated ab twists)
• Lying flat on your back for prolonged periods (after 20 weeks)
• Any exercises or movements that cause "coning” or “doming" of the abdomen (tends to occur if you try to perform crunch-type exercises in your late second and third trimesters)

If you are accustomed to resistance training or running/walking and do not have any pregnancy complications, it should be safe for you to continue the same workout routine throughout the first trimester of pregnancy. You can also start with the Week 12 routine below.

If you are new to exercising, we recommend you start with the Week 1 routine and progress through the weeks, gradually increasing your exercise each week.

Be sure to read Reasons to Discontinue Exercise before you get started.

First trimester exercise routine

Week 1:

• Cardio: 15-minute walk, twice this week
• Strength: 20-minute session, once this week
• Stretching: 10 minutes, four days this week

Week 2:

• Cardio: 15-minute walk, three days this week
• Strength: 20-minute session, once this week
• Stretching: 10 minutes, five days this week

Week 3:

• Cardio; 18-minute walk, three days this week
• Strength: 20-minute session, twice this week
• Stretching: 10 minutes, six days this week

Week 4:

• Cardio: 20-minute walk, three days this week
• Strength: 20-minute session, twice this week
• Stretching: 10 minutes, six days this week

Week 5:

• Cardio: 20-minute walk, four days this week
• Strength: 25-minute session, twice this week
• Stretching: 10 minutes, six days this week

Week 6:

• Cardio: 22-minute walk, four days this week
• Strength: 25-minute session, twice this week
• Stretching: 10 minutes, six days this week

Week 7:

• Cardio: 25-minute walk, four days this week
• Strength: 25-minute session, twice this week
• Stretching: 10 minutes, six days this week

Week 8:

• Cardio: 25-minute walk, five days this week
• Strength: 25-minute session, twice this week
• Stretching: 10 minutes, six days this week •

Week 9:

• Cardio: 25-minute walk, six days this week
• Strength: 25-minute session, twice this week
• Stretching: 10 – 15 minutes, six days this week

Week 10:

• Cardio: 27-minute walk, six days this week
• Strength: 25-minute session, twice this week
• Stretching: 10 – 15 minutes, six days this week

Week 11:

• Cardio: 30-minute walk, six days this week
• Strength: 30-minute session, twice this week
• Stretching: 10 – 15 minutes, six days this week

Week 12:

• Cardio: 30-minute walk, six days this week
• Strength: 30-minute session, twice this week
• Stretching: 10 – 15 minutes, six days this week

Congratulations! You’ve reached the end of your first trimester. You’ve gone from perhaps no or minimal exercise to now meeting the recommended daily exercise goal. Way to go!

If you are new to exercise, we recommend you start with the first trimester Week 1 exercise regimen and progress through the weeks, gradually increasing your exercise each week.

If you have been following the first trimester workout protocol, you can continue to increase your daily exercise to the degree you feel comfortable.

In general, you will likely find that your energy, exercise tolerance and exercise ability increase during your second trimester.

Things to avoid while exercising during the second and third trimesters:

• Valsalva maneuver
• Hip extension past neutral (walking lunges, back/hip extensions, glute "kickbacks")
• Deep twisting through the torso (oblique twists/spinal rotations, seated ab twists)
• Lying flat on your back for prolonged periods (after 20 weeks)
• Any exercises or movements that cause "coning" or "doming" of the abdomen (tends to occur with crunch-type exercises in your late second and third trimesters)

If you are new to exercise, we recommend you start with the first trimester Week 1 workouts and progress through the weeks, gradually increasing your exercise each week. The third trimester can be challenging and tiring. If you feel overtired after exercising, we recommend sticking with the same exercise regimen for 2 to 3 weeks before increasing the regimen, or if needed, decreasing the regimen.

If you are used to exercising heavily, you may find that you need to decrease your exercise load in the third trimester. It is normal to begin to feel more fatigued during your third trimester.

As your exercise capacity may decrease in the third trimester, you can spend more time stretching during this time.